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this morning, my question. what can we learn from harper high in chicago? plus, detroit. the city where democracy may be dying. tired of all the good races? first, bring it down a little bit. it's all irrational exuberance about the dow. good morning, i'm melissa harris-perry. hear that? on friday, the closing bell seemed to have a special ring to it. because the dow jones industrial average jumped up 67.6 points to 14,397. that was the sixth straight daily gain, a new record high, an all-time record high. it was the highest number the

dough's ever been in 116 years and the standard and poor index added seven points landing 1% shy of its october 2007 all-time high. the nasdaq ended 12 points, $10 trillion has been restored to the u.s. equities. it took the market 65 months to do it. woo-hoo. what the what? i think we need this guy to help us out. >> how do we know when irrational exuberance has unduly escalated? it then becomes subject to unexpected and prolonged contractions as they have in japan over the past decade. how do we factor that assessment into monetary policy? >> despite the fact it sounds as though greenspan never

experienced irrational xub ra z exuberan exuberance, they are the two most important words. they held so much weight that they helped place the pin in the dot com bubble that burst in the 1990s. i'm thinking a different kind. all the numbers on wall street add up to just about zero for main street. the metric we are using to measure how fantastic it's doing, it's irrationally exuberant. it's not a new high. it doesn't account for inflation. if it did, it needs to rise 10% to hit a real all-time high. the dow isn't a generic indicator of the health of the entire economy or the markets in particular. it's a snapshot of how, well, 30 years or so, blue chip stocks

from publicly owned companies are doing. that tells you those 30 corporations are doing well indeed with the help of massive layoffs and cost cutting over more than $2.3 trillion in fed stimulus that helped push investors back in stocks. the stocks are high because the fed kept the interest rates so low and moneybags investors want to put their money somewhere. the gains on the market became so unrelated, the vast majority of americans the term irrational exuberance means something to those of us not on wall street. you don't have to crunch the numbers to understand this index. the line you see here, shooting nearly straight up, it's corporate profits since 1970. the other line, staying just about flat and starting to tip down, it's labors share of income. so, yes, we were happy to hear for 29 months in a row, the working economy added jobs,

bringing unemployment down to 7.7%, the lowest since '07, but they haven't recovered the jobs lost to the recession. we are still living through the worst labor market recovery since world war ii. in part because all the corporate productivity isn't producing jobs. the official end of the recession in june, 2009, payrolls remained flat while corporate spending on equipment and software shot up. yes, corporations are investing in machines, not man. this irrational exuberance is only for those not at the top. up there, up at the top is looking like a pretty a-okay recovery. take it from jaime diamond, he said casually last week to investors, this bank is antifragile. we actually benefit from downturns.

he's not wrong. during just the first two years of the recovery between '09 and 2011, the top 1% captured 120% of all income gains. that bottom 99% continued to lose ground. it might be irrational exuberance to think that is what recovery looks like. with me today, to set the world to right, msnbc policy analyst, ezra klein, editor of the blog for "the washington post." carmen, a personal finance expert. organizer for the campaign, stephen, the ark tech for justice for campaign. lisa cook, michigan state university professor of economics and international relations and former member of president obama. are we or are we not in an

economic recovery? >> we are in a recovery, just not a good one. you did a great job in the open. we are not having a high in the stock market. the people irrationally exuberant are in the media. >> it happens. >> we are at a lower point than 2008 because of the lack of inflation in the dow and the s&p than in 2000. it's a worse stock market than we had more than 10, 12, 13 years ago. the idea that we are irrationally exuberant about that is ridiculous. we are misreading numbers. >> which we tend to do. >> all the time. >> we have difficulty in understanding how the economy ought to be measured. >> the one good thing that happened is not that we passed a fake threshold, we gained more than 200 jobs in february. that is a big deal. if that keeps up, if congressmanages not to get in the way of that, it's something to be exuberant about.

fake ticker tape is ridiculous. >> that's news that unemployment has gone down. that's the big news. what's scary here is we are seeing a split. we can talk about the wealth cap. most of americans are not the investor class. they don't participate in the market. the markets where they have advantages, the housing market. it's gone up a little bit. not so much as the stock market. here is the thing -- >> i want to show, we have data on this. >> good. >> as ezra was talking, we have difficult the visualizing this. when we look at who was invested in the stock market, 90% of the people with incomes of 100,000 or more, they have investment in the stock market. it declines. most of it is retirement. you see it is wealthier folks, higher income folks. >> absolutely. over 50% of the capital gains

that have been taken in the last couple years are actually that 1% or that .01% of folks. we can look at the great charts and graphs that show when the income of capital gains started being taxed so low at 15%, it coincides with the gap widening up. it used to be tax income. wealthy people, their income is not a paycheck, it's returns on the market. >> the labor share of income, weekly wage growth is not growing, it's going down. this is a fragile recovery. we say 36 straight months of job growth. that's fantastic. this is uneven, not just on terms of who it benefits, but wage growth. it's income growth. in terms of wages, this is still something that is fragile. this is uneven, too, in terms of who is benefiting in what parts of the country.

we'll talk about the jobs report -- >> i don't want to miss that. there were a cupping things i want to make sure we are clear about. capital gains are taxed at a lower rate than wages. when you earn these wages, you are paying out more in taxes. >> mitt romney paid 9%. >> it's the buffett rule. >> it's not a chart, but everybody i talked to said the stock market is at a new high, what do you think? >> the response was to burst into laughter. everybody said maybe it's good, but it sure isn't helping me. >> what's bad is individual investors get in at the wrong time. you have folks that panicked and pulled their money out. now, they are going saying oh, look, it's going up. >> it's worse than that. you have people who did it and had to spend it during the recession. one thing we lose in the

so-called recovery is how much regular people are devastated. it's like the car accident. at the end, one person who caused the wreck, he's back in health and the other person lost a leg and arm saying this recovery is great. >> if you had to eat your house or eat your retirement, lick wii dade it and eat it, as we come back, the loss of wealth is dramatic. we are looking at a country where nearly 30% of americans don't have savings accounts. 10% of americans don't have checking accounts. the idea that is operating at the same time of this so-called recovery. >> if you see the costs, too, for most of americans. medical costs have gone up. the things you actually have to buy, whether it's the cell phone and internet. everything has gone up. you see this top class where everything has gone up so tremendously. what does that mean and what is it going to mean going forward?

>> part of what is happening in the stock market, it is going up. that is in part a commentary from the market. it is a belief the economy is going to grow. the economy is going to become real. we are not trapped in a slow growth normal. we will not see a real house in recovery. >> a recovery for who? >> when you look at the housing side of it. >> stick here. sometimes it's the only truth that matters in the context of the economy. let's stay here. when we come back, i want to look at the chart you said is going viral. we'll talk about that when we get back. introducing new febreze stick & refresh

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well, inequality is old news in this country, the carnegies, rockefellers are the aged elders of today's puffettes. when you ask americans how this wealthy nation's abundance should be distributed, this is what they say. the yellow portion on the left is the share we think the country's wealthiest few should have. the orange is the upper middle class share and the red is the middle. the gray block on the right is the poorest and the share we think they should have. that's what we think it should be. the ideal way to distribute wealth. we know this is not the reality. if you ask how well it's distributed people think it looks like this. the rich have a huge share of the wealth and the poor still have something. here is the deal. here is what the share really

looks like. in reality, we are way, way, way more unequal than we even thought. the wealthiest 20% among us hold 80% of the assets in this country. you can barely register the poorest among us. that line, barely, you can't even see it. that's what the reality is there on the top. that data is the graphical representation of the false consciousness, the gap between rich and poor, we don't have a handle on how bad things have gotten. you were talking protection. this is the perception i'm worried about. >> this is scary. we talk income and equality. we are comfortable talking it. when you talk about what we worry about stemming from that, political power, wealth and equality is important. you have somebody who got rich. they had a top income, a trader or something. they don't have enough money to be trying to influence a

political system. when you talk the 1% of wealth, they have the stability in their fortune to try to use it. when talking social mobility and investing in children or buying a home, the capacity to climb up that ladder, it's coming from that wealth, not a single year's income. the wealth and equality is -- there's a much larger disparity in income and equality. we talked about it less and are unclear of what to do to solve it. >> it's more important. >> in terms of middle class wealth, most of it is tied up in housing. this is one-third below peak. if we are talking a broad based recove recovery, it has not been. >> this is why african-americans lost their wealth. the groups of people that put all their money, any money they have into something that functions like the stock market. it's a market. i know we have a lot of tradition of owning a home and

making sure you own that property. the problem is, it's volatile. it's a volatile thing and controlled by a market you don't have control over. it can destroy you. >> the thing about housing, this idea that it's recovering, it's recovering for some people. a group called ace is putting out a report. $3 billion and more in foreclosures for wells fargo. there's a pipeline. there's two economies going on. in communities of color and all over, it's not just foreclosure, it's being under water. there are things to do. we could rewrite mortgages and put $1 trillion in the economy and create jobs if we fixed housing for regular people, not just banks. >> the wells fargo story is uglier than that. it's not just volatile, they sold a certain kind of product to poor communities and the communities lost value. you end up stuck. you can't move for a labor. >> they weren't alone.

>> they were just -- agreenlgous. >> watch this loop. why did a lot of homes go under? why couldn't people afford their homes? jobs. the jobs weren't there. why are there no jobs? corporations are hoarding cash, they are holding on to cash. the stock market rewards them because they love a fat balance sheet. this is a vicious cycle. >> there's a third part, right? so jobs go down, part of that is because corporations are hoarding cash. the other thing is because the public sector is shedding jobs. >> yes. >> we see this number the other day. if we held it straight, if we had not cut a single public sector job, we would be at 7.2% unemployment. if we were adding at the rate we were adding in the george w. bush era we would be well in the 6%. one thing we know how to do is we can create public sector

jobs. it's not rocket science. if we want to hire 100,000 teacher's assistants, wokd do that. there was a proposal to do that. there was a consensus in washington that was inefficient. it's old school liberalism. one of the big mistakes was to focus little on job creation. >> the deficit. if we start adding government jobs, you are adding to the deficit. >> i think there's, in a strange way, a relationship between housing and government. the same predatory loans that people were sold in their homes have been sold to local governments around the country. >> yes. >> these incredible deals in california where, you probably remember the school loan. they don't get paid off for 20 years. what wall street did is not just bankrupt homes and people, it's bankrupting government. one of the things we are

working -- we need to re-negotiate the debt. wall street got bailed out. re-negotiate the debt. something exciting is happening in oregon. the public employee union put in demands that there should be no cuts to public service until the state sues and gets money back. we have to get back what they stole and not say recovery. we stay where we are and they get mega -- >> i love this narrative it didn't just bankrupt you and your household, it bankrupted whole cities. we are going to talk about detroit later in the show. this frames it. there is somebody who owes back to these communities. more after the break. as good as the monthly unemployment numbers were, there's a glossed over troubling figure in there that we are going to dig up next. we're here! we're going to the park! [ gina ] oh hey, dan! i really like your new jetta! and you want to buy one like mine

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remember all that excitement abdomen the dow, the dow, the dow? guess who benefited from it? the 100 wealthiest people on the planet added $28.7 billion to their net worth this week. excuse me? because i added none. i'm doing way better than the average american. >> certainly we should celebrate the fact that our retirement plans are doing better and corporate profits are recovery. this is 54% of the population that own stock. we should be careful about the implication. people feel better about household wealth, so they start spending. if we have had permanent damage in the economy and the

assumptions we have don't hold they don't spend. we need more consumer spending. we really have to be careful about this irrational exuberance. middle class wealth is caught up in housing. >> i feel like sometimes what's good for the economy, for you to go out and spend. if i hired you to be my wealth adviser, you would not sago out and spend. you would tell me save, put this away, put this to the side, right? >> i tell you buy back at a discount and sock all this money away into well diversified portfolio. we don't know what is going to burst. we don't know what bubble is going to go. interest rates are going to rise. we have a global, high frequency trading that we can't predict as regular americans. you have to make sure you have a plan in place. i don't think that a lot of thing that is help many americans are going to be there for long. this is something you have to be

very, very careful of. this is an interesting market, get help. >> buy a bag and upgrade your car. we have had our cars for longer than we have ever kept our cars. >> jane, did you hear that? my guest just said we should upgrade our car, dear. >> 2.9% interest, that's great. 1% of jobs in america is created to the car industry. you are creating a job. >> i should buy a ford or a chevy. >> i want to throw out something that may fit into this. there's two pieces that connection. the other is the question of student debt. >> oh, no. >> i just want to connect it to something that is so insane that just happened. i don't know if you heard about the mcdonald's workers that went on strike in pennsylvania. >> yes. >> they are students from other countries that came here on student visa's for cultural

experience. they were making minimum wage, living in the boss's basement. they paid to come to america and rent the company store. it's not that it's horrible, it speaks to something going on with the economy. they are not content with minimum wage. they are scheming. when i think of buying a car, i'm with you. there's more and more people that the thought of buying a car is debt. you can track student debt now to the housing market in wisconsin. they did a study that housing and car sales are down because people cannot get a loan. >> we can impact that changing how they finance cars. >> we defunded public education. the private sector, in the name of efficiency drains billions out in wall street in excess -- we spend $1 billion a year in debt collection on student loans. >> the other thing that happened, this is what we are

not doing a good job with. health care and education, which are eating up enormous amounts of paychecks have the same problem. families don't feel they can say no to whatever they are charging. they can say no to the hospital when your loved one is in it. you can't say no to providing your kid a college education. they are getting way, way, way into debt. the government funds these debts. they don't demand good prices for it. >> when talking social mobility, it's not just wealth, it's the human capital, which now, again, that same distinction is occurring. only the wealthiest families can begin to imagine. >> it's a story we have to worry about the damage that was done in this economy through this recession and this recovery. for example, one bad piece of new that is came out with the

job report is that we are now seeing average duration of unemployment going from 35 weeks to 37 weeks. what does that say about the students we are training? the teachers -- the teachers who should be teachers are working at dominos. those skills are going to atrophy. >> we needed another hour. the irrational exuberance, we are only scratching the surface. i want to take a moment to express my exuberance for the wonderful crew working the floor here at the studio. they make magic happen in the blink of an eye. their work, making room for 14 harlem shakers during a brief commercial break last sunday is worthy of extra gratitude. we love you all. late up next, why people are saying detroit is where democracy goes to die. both tylenol and bayer advanced aspirin

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all cities have their share of problems, but what happens when the city itself is seen as the problem? at the start of his 1903 text, "the souls of black folk," between me and the other world, there is ever an unasked question, how does it feel to be a problem? see the difference? not how does it feel to have problems, but to be a problem? i was reminded of the question as i followed the news out of detroit. the city does not just have problems, it's treated as though it is a problem. earlier, the governor announced the city will be led by an emergency manager. that person will not be elected. he or she will be appointed by michigan governor, rick

schneider. they will have power of the officials to address detroit's $14 billion plus debt, an assorted financial troubles. detroit will become the tenth city on the list to have an emergency manager. four of them don't have an african-american population. the other six, including detroit do. michigan is foreclosing on the cities, treating them like they have problems. is this how democracy dies? joining me is president of the national action network, michigan chapter. so nice to have you here, reverend. >> thank you very much, dr. perry. we appreciate your journalism. >> let me ask you this. why this assumption detroit's problems are too large to be solved by the city itself? >> you know, dr. perry, we sprung our clocks forward today.

but the governor is certainly trying to take us back. democracy is at stake here in detroit. our voting rights are at stake here in detroit. there are many across the state of michigan who wish to take the city of detroit and sell off its assets. i was watching your program earlier today. you outlined the problems that detroit has. that are national problems. that's unemployment. that's the housing crisis. these are the reasons we are facing the fiscal crisis we are facing. if we allow this to happen in detroit, which we are going to fight this all the way, michael nutter in philadelphia will be next. atlanta will be next. this will be spread like wildfire. >> exactly that. when you point out the other cities and the other mayors and elected officials, we talked a lot in 2012 about voter suppression. this is the ultimate voter suppression, right? the person making all the

decisions is in no way accountable to voters. >> absolutely. i don't have a mayor who i can go to and say my street light is out, my garbage is not being picked up. the park is not clean. i cannot go to my city councilman and say my street needs to be cleaned. this totally roots out democracy and the ability for accountability to our elected officials. this is why there are so many people in detroit, as you have been reading in the headline that is are upset about this. we are going to continue to fight this and we are going to fight it to the very end. >> let me ask you this as well. labor is going to take a hit here. there's going to be a tough piece, labor is going to lose bargaining rights. what about wall street? how will that relationship be similar or different under an emergency manager?

>> what's unfortunate about this situation is detroit owes our banks. we have hi-dgh deficits. he's trying to not have to go to the table with the banks and have them re-negotiate the debt that detroit has. it's interesting to me, dr. perry, we bailed out the banks at $1.7 trillion and now urban centers across america who owe the banks, the banks have not done anything to sit down and say let us re-negotiate the terms, population is down, jobs are down, foreclosure is down but banks profits are up. >> to play devil's advocate, if i'm a nay sayer, i say the elected leadership failed. you had a chance and failed. why not bring in an emergency manager? >> my question is simply this to

that, democracy worked for 100 years. the michigan governor, the state of michigan was in a deficit, is in deficit now. should the president come take over the state of michigan? should the united nations take over the united states? it's not how democracy works. it's a pole tax on detroit and others across the state of michigan. you know, how can we be in a state where almost 75% of the african-american elected officials won't have the ability to fulfill their position because they will be under emergency management. this is a national crisis. we need folks to really look at this and begin to help us here in detroit, send a message to the united states department of justice. we need federal intervention. the king had to ask kennedy for intervention for montgomery and

voting rights. we are doing the same thing. we need you. go to@nationalnetwork, the twitter site. help us out here. >> i like the idea of sending an emergency manager to congress. they seem incapable of doing the business of the government. i appreciate it. >> absolutely. >> so, up next, is race a factor in your health? [ male announc when it comes to the financial obstacles military families face, we understand. our financial advice is geared specifically to current and former military members and their families. life brings obstacles. usaa brings retirement advice. [ sneezes ] [ sniffles ] [ female announcer ] for everything your face has to face. face it with puffs facial tissues. puffs has air-fluffed pillows for 40% more cushiony thickness. face every day with puffs softness. [ bop ] [ bop ]

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rewards we put right back into our business. this is the only thing we've ever wanted to do and ink helps us do it. make your mark with ink from chase. for current and former military members and their families. get advice from the people who share your values. for our free usaa retirement guide, call 877-242-usaa. get your pencils out, nerdland. it's time for a pop quiz. there's one question. first, you need a few facts to help you with your answer. ready? first, babies born to african-american mothers are more likely to die than any other race. death rates for african-american babies are nearly twice the national average. did you know african-americans and native americans are twice as likely to be diagnosed with

diabetes as white americans and that african-americans with diabetes are more likely to suffer complications like renal failure and amputations of the legs and feet. did you know african-americans are the racial group with the highest rate of hiv infections. they account for 44% of all new hiv infections among adults and adolescence. they represent 13% of the population. did you know african-american men and women are 30% more likely to die from heart disease than white males even though only 6% of african-americans have heart disease. did you know african-american women are less likely to develop breast cancer than white women, but 40% more likely to die from it. they are most likely to die from breast cancer than any racial group. now, here is the quiz. do that he has disparities among

african-americans exist because there is something broken about their bodies or because there's something broken about their lives? pencils down. i have guests at my table who are going to give you the answers, next. ha ha ha! no no no! not today! ha ha ha! ha ha ha! jimmy how happy are folks who save hundreds of dollars switching to geico? happier than dikembe mutumbo blocking a shot. get happy. get geico. fifteen minutes could save you fifteen percent or more. plays a key role throughout our lives. one a day women's 50+ is a complete multivitamin designed for women's health concerns as we age. it has 7 antioxidants to support cell health. one a day 50+. will restore even skin tone? think again. introducing olay professional even skin tone.

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a useful model for understanding race in medicine can be found in american folklore. it's a story told about the black men who worked as day laborers in the 19th century. their hero, john henry was the strongest, most powerful steel driving man working on the railroad. one day, when the salesman showed up with a drill, john henry facing a challenge to strength and skill agreed to a contest against the machine. when the dust cleared, john henry drilled 14 feet and the machine nine. he had enough time to raise his hand in victory before he

collapsed and crashed to the ground. he died from a heart attack. he lives on in the field of cardiology where the term john henryism is used to describe health despairties for black men. men driven to push their bodies to circumstances beyond their control and suck coming to the forces coming against them. here with me at the table, ann, assistant professor at georgia tech and author of "medicating race." founder of the harold p. freeman institute and ralph lauren center for cancer care and prevention. alandra a professor of columbia university and author of "body and soul." you remember from yesterday, dr. jonathan, professor of psychiatry and author of "the protest psychosis."

what does race have to do with cardiovascular health? >> a lot. what my book looks at is the history of heart disease research in the united states. since the founding of heart disease as a research as a field. what i found is that throughout heart disease, researchers have been interested in asking questions about a diz that is understood to be related to the american way of life. early on, heart disease researchers were focused on elite, white men and the stressful lives they were living that were sedentary. a lot of people were left out of that story. with kind of the progress and democracy that has happened through social justice movements, the notions expanded. we saw in the post war period, both white men and women including new white immigrants being studied. with the civil rights movement, there was a lot more interest and attention in the lived

experience of african-americans which include lived experiences of heart disease. >> i can imagine there are people watching right now who think wait a minute, didn't she ask a question about heart disease and social movement and race and identity? you know start emerging. why are we talking about that when we are talking something biological and medical? >> because health is politics by other means. health is a terrain, a space in which we struggle with access to resources. whether or not one is healthy has to do with access to resources. itis not what ann's book shows so well is it is about social justice and about how communities are trying to get access to the medical system. it's been historically segregated in american society. i think it's also about the class issues. the part of the john henry story that you didn't raise is he was a former slave. he's a former slave working in the context of sharecropping.

this is about a time and context when black laborers were supposed to work themss to death. in a more contemporary movement, you think about it now and people work because they have to work. you are driving yourself not only because of ideas of masculinity, black masculinity, because you don't have health insurance and if you do not go to work you do not get paid. the driving is not only about a personal disposition about being hypermasculine, but a social context that forces people to work when they shouldn't. >> so, bring that all the way down for me, jonathan. we are still in a land of access to resources and what does that look like on the ground if i am a, as many, african-american women are, a small business owner and i do hair. right? i'm earning a decent income. i'm sick and cannot do hair that day. i get very sick and don't have

health insurance. what does this inequality look like on the ground? >> in the quiz you asked the viewers before the break, you asked a trick question, is it cultural or biological. i teach if you vote, it's cultural or biological, if you say it's one or the other, you are not going to pass my class. it's both, in a way. like john henryism and ann's book show is social factors, oppression that are invisible and privilege have profound biological implications. if somebody is working against, you know, factors in society that make it hard that they can't afford to lose a day of work or something like that, it will impact their biology. what we look at is not just culture. everything is socially constructed. it's influenced by culture. it's a radical notion in medicine. >> i was reading about the decades of work you have done at harlem. this is the insight that you

initially had. here i have been trained as a doctor to treat bodies. you came to harlem and found that is insufficient. >> absolutely. it comes to the fundmental question, what is race. we have to make a distinction between what we call race and what racism is. so, how do we get to be black in america, for example? through the one drop rule. what is that? it came out of slavery. so, when a person owned another person who was a black slave, they didn't want to lose that person to mixing up races. by the time of the revolutionary war, for example, there were slaves on plantations who appeared to be white. they were called black. what ultimately occurred was the one drop rule meaning you have one ancestor, no matter how far back in time, you are black. in harlem renaissance in 1920,

it was taken up by black americans of all colors. they resisted this false concept of one drop rule mess, which is ridiculous. >> right. >> they decided, okay, let's call ourselves all black. they are treating us all the same anyway. there was a con ver jengs, a fall rule. now people who are black by the rule don't say i'm not black. >> right. >> it's not a biological issue. >> yet, it's real, right? on one hand we want to say it's not a biological reality, but has real biological implications for our health. >> absolutely. i think this is one of the ways that it's important when talking about race in medicine to move beyond talking race in genetics. genetics can't change in a clinical encounter. they don't change over the course of an individuals life. biology does and can change. i's what makes it really urgent

sight to pay attention to. our lived experience is going to happen in our biology. it makes it less depressing than statistics. that means social change can -- >> when we come back, i want to ask about patient navigation and can we cure race and or racism with a pill. we like to do everything with a pill. stay there. ira glass from "this american life" is coming to nerdland in the next hour. we are going to talk about why all good races can be exhausting. more nerdland at the top of the hour. ♪ [ instrumental ] [ girl ] when i started playing soccer, i wasn't so good. [ barks ] so me and sadie started practicing. we practiced a lot. now i've got some moves! [ crowd cheering ] spin kick! whoo-hoo! [ giggling ] [ announcer ] we know how important your dog is to your whole family.

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lymphoma, other cancers, nervous system and blood disorders, and allergic reactions have occurred. before starting enbrel, your doctor should test you for tuberculosis and discuss whether you've been to a region where certain fungal infections are common. you should not start enbrel if you have an infection like the flu. tell your doctor if you're prone to infections, have cuts or sores, have had hepatitis b, have been treated for heart failure, or if you have symptoms such as persistent fever, bruising, bleeding, or paleness. since enbrel helped relieve my joint pain, it's the little things that mean the most. ask your rheumatologist if enbrel is right for you. [ doctor ] enbrel, the number one biologic medicine prescribed by rheumatologists. welcome back. i'm melissa harris-perry. tucked away within the 2400 pages of the affordable care act in section 3510 is a word that might seem more at home in

transportation policy than a health care law, navigation. it's used in reference to the patient navigator that the law reauthorizes through 2013. you have probably never heard of it. it received barely a mention in the back and forth of the drafting and implementing of the aca. a fragmented health care system for medically underserved population is what the practice of patient navigation is about. patient navigators are guides to help people find their way through screening, diagnosis and treatment, sticking to a regime for care. navigators lead their patients from beginning to end and scare them toward quality care. a george washington university study found women who used

navigation services received life saving early diagnosis four times faster than those who didn't. in the health care policy, patient navigation is an approach that actually works. at my table is the man who started it all, two decades ago when he saw african-american women dying of breast cancer at an alarming rate. also at the table ann, author of "medicating race." a professor at columbia university. doctor? >> yeah. >> so you are looking at this higher death rate among african-american women and the answer wasn't a kind of medication for them or even personal -- it was patient navigation? >> yes. here is the background. some 40 years ago, i came to harlem as a cancer surgeon. i faced women who come in with

breast cancer where the mass was bleeding and ulcerating when they came in. unacceptable. 39% survival rate of those women before intervention. i did two things. i found a way to screen those women for breast cancer including a mammography by 1979. that helped. it wasn't enough. i held hearings as president of the american cancer society cancer in the poor. out of those hearings, we found all american people who are poor face barriers trying to get into and through the health care system. something called patient navigation at harlem hospital. essentially, we put people on the case. the patient comes in, sees a doctor, navigator takes them aside, did you understand what the doctor said? probably often not. explain it then. is there a barrier to you getting the biopsy to what is

recommended? i don't have insurance. we have to solve that. babies at home alone. navigators solved the problem. the problem is broad. it starts with people living in a neighborhood. they have to be navigated to a place to get an examination. examination must be done. it's a mammogram. when there's a finding, be sure the patient gets rapidly to diagnosis, people are lost. >> i'm thinking, that requires a way of understanding the patient as a full person, right? not just as a diagnosis. it feels different to me, the part you write about in the book, looking at the cardiovascular difference. having a prescription that is for black bodies and not a prescription that is for poor lives. >> yes and no. actually, i think a lot of the way it merged is from the same kind of practices.

the organization that ran the clinical process was a black cardiologist. their approach is holistic. they found medications is being one component alongside things like, for example, training church cooks in hypertension lowering diets. places with barriers to access. all of those things can go together. it's different when you look at it in the pharmaceutical market. there's a gap there. from the pharmaceutical company's perspective, they wanted a racially specific indication for the drug. that way their patent life is extended and they can make more money. >> the pharmaceutical piece makes sense. i know your work. there are times when on the one hand you are looking at health disparity, there's a pharmaceutical solution, what is

the thing we are diagnosing with is racialized? >> i'm sure viewers of the show might be thinking how can we have it both ways saying race is social but doctors treat biological findings. studying the history of race in medicine is not telling us about the genetic basis of serotonin. there's a basis of how social factors -- during the 1960s is an example. the rhetoric of mental illness was mirrored. popular anxieties. all of a sudden, there's one there. people are probably like hey, i woke up and there's james brown. that was an ad for in the american journal of psychiatry from 1968 after the detroit riots. in a way, history shows us that right after this incredibly

politically charged moment, the rhetoric of what mental illness was mirrored a social reality. it's not to say doctors are racist, we need to be aware because we are surrounded with assumptions of race and health that we need to be aware of. >> this month marks the diagnosis to drape to mania. if you are an enslaved person who wants to be free. not if you are an enslaver. racism is not the mental illness, the desire to want to be out from under it. >> one of the interesting things, in the same period jonathan is writing about with the black power period, where they are overexposed to the bad things about medicine. it's where health activists are starting to mobilize in part because you have the advances of the legal changes and the civil rights act. it brings relief to all that

remains undone. it becomes more acute or comes into view. so -- >> it becomes clear sitting at the lunch counter or integration of the schools or hospitals. >> also jim croweed as well. part of what they were doing is a preliminary effort at the wonderful, you know, patient navigation system that dr. freeman is doing. clinics would have patient advocates and the person would be, you know, is there led in your home? do people not have access to food and these sorts of things. there's a longer historical trajectory to the work. >> this patient navigation, we are thinking of it as a policy because it's in the context of aca. it begins as a social movement activity. >> it does. it's driven by three things, in my opinion. one of them is poverty and lack of insurance, a circle of

poverty. the other is how people behave, the culture and the good culture and bad culture. they are not related to race directly. there's social injustice. they overlap and drive disparities all the way to the end of life. navigation is an attempt to look at the total continuum and knave gait people from where they live, through health care and treatment, quality treatment to the end of life. it seems to work. we changed the five year survival rate at harlem from 39% to 70%. >> wow! >> screening and navigating. >> for all of the depressing of what it means to think about these inequalities, that's the point i want us to leave on. you changed the survival rates. it can change whole communities. thank you to ann, dr. freeman, jonathan is going to be back in a bit. up next, the high school on the front lines of the gun violence

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last year, one chicago high school lived through an unbelievable amount of gun violence, 29 current or recent students shot over the course of the school year. the school is harper high. just more than six miles from where this teenager was gunned down days after performing at president obama's inauguration. three reporters from chicago produced radio show, "this american life" were given unprecedented access to the

school. they shadowed students, staff and faculty and cake away with stories. listening, we get to walk along with these kids. it is not a simple thing to walk with these kids. >> we feel like this. for some reason, we deal with it. we never liked passing trees. there's too much stuff going on. >> reporter: too much stuff going on is the shootings, the fights, the craziness. it's better to walk down the middle of the street where you can keep a broad view of things and where you have a few more seconds to run, if you need to. >> that fear is not a phobia, it's a reality. pretty soon, you can expect to see yet another person shot. >> football who's been shot or shot at? >> probably the whole team except freshmen and sophomores.

>> i think everybody was shot at. everybody on the team. >> maybe the most stunning part of the story is that harper high is not an unprecedented exception. it's one of many schools trying desperately to educate thousands of kids living in a reality we try to imagine. we can glimpse the helplessness and hopelessness, the constant innocence in their voices. here to help us delve deeper into harper high is the host of the show, ira glass and principal of harper high. how are you this morning? >> good morning. how are you? >> i'm a little in love with you. i'll tell you that spending time listening to this series, the love with which you are trying to shepherd these young people

through harper is tangible and extraordinary. it was hard for me to listen to it for two hours. you live with it daily. what do people need to know? >> people need to know that first of all kids are kids. the students at harper high school are wonderful children. i'm so blessed to be a part of harper high school. i'm so blessed to have the staff that i have at harper. i have one of the most amazing staffs in the city of chicago, if not across the country because they are so passionate. they are so dedicated to our children. we don't know what our children go home to every day. to bring a little bit of sunshine to their lives for the hours they are at harper is an extraordinary thing. i'm excited and blessed to be a part of this even though the

challenges we face is an awesome thing to be a part of. >> that tone we just heard from the principal there is infectious in that it keeps coming through in these circumstances that are, again, hard for many parents and listeners to imagine. you get the sense that somehow the teachers, the students are just trying to make it through this. >> yeah. i mean one of the reasons why we wanted to cover this story, we are looking for a place to be able to talk about the shootings happening in chicago. shootings are up there versus big cities in the country. one of the reasons we chose harper is to watch this staff try to deal with the kids and help the kids and get the kids through. it's interesting. there's a growing body of research now about the effects of stress on kids as they come up in bad circumstances and how it makes it harder for them to learn. their brains are developing differently.

one of the things we know from this research is various points of a kid growing up, you can intervene. watching what happens, what principal sanders and her staff do in a day-to-day way, when you reach adolescence, you can intervene. they are doing the common sense thing of having enough people around to get to know the kids and having them think through and dealing with the effects of seeing so many shootings and dealing with the danger in the neighborhood. deal with what it's like to be a kid, the normal stuff they are going there. >> i want to pause on that. this idea, the confidence of your staff, there's a moment toward the end of the stories where they allow you to just riff on what you would do if you won the lottery. i want to listen to that for a second.

>> i would hook harper up. everybody would be there. >> she weighed out hr plan. >> i would say yeah, they would have the state of the art labs, every student would have access to a computer. any of the capital resources that we needed. >> it goes on and on. i keep thinking why does this have to be a dream? why do you have have win the lottery for it to be true? >> you know, i think that a lot of schools are challenged with having the resources that they need. upon entering harper, approximately six years ago, it was really brought life to me. a lot of students go without the resources they need. so, for harper, there are so many things that are still

needed. when we first became a turn around school, the resources and the human capital brought into the school was awesome. it was what the school and the entire school community needed at that time. we must continue that. you can't replace the human side of people. however, you know, we have to continue to persevere, you know, through whatever challenges lay before us coming forward. so, having things such as, you know, exposure for our kids to go on college trips, if i was to look at a segment of post secondary, having students be exposed to go to colleges. some of our students are first time college students. they don't know when they go away to college they need all the things they have to take with them for a whole semester because some of them may not come back before christmas break. in other words, they need to know they need personal items.

a lot of our students don't have money for housing. when they are accepted to schools. a lot of times, that comes out of our pockets to provide the housing costs for our students as well as transportation. many of my staff have gotten into their personal cars and taken students to schools because it's an issue. you know, we get the books, we get things like that. there are a host of other accessories and things kids need that, you know, we have to provide for them. we do it because they are our children and, you know, it's the need. we have to do that. >> principal sanders, i just -- there are not words for what you and your staff are doing. i know harper is just one of many schools struggling with this. it's the school many of us had the opportunity to fall in love with through this reporting. i promise you, we are going to keep our eyes on you, on harper and the children there and not

forget they are children. thank you very much. ira is staying with us. when we come back, much, much more on harper high school. my mother made the best toffee in the world. it's delicious. so now we've turned her toffee into a business. my goal was to take an idea and make it happen. i'm janet long and i formed my toffee company through legalzoom. i never really thought i would make money doing what i love. [ robert ] we created legalzoom to help people start their business and launch their dreams. go to legalzoom.com today and make your business dream a reality. at legalzoom.com we put the law on your side.

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it will if it's new outlast stay fabulous foundation. it's a primer, concealer and foundation in one for all day flawless skin. new outlast stay fabulous from easy, breezy, beautiful covergirl. startling as it is to hear about the 29 recent or current harper high students shot in one year, more startling is the amount of students impacted by the violence by bearing witness to it. we can't give you an exact number for how many students have personally seen a shooting or the aftermath, based on the reporting done on "this american life," it's fair to say nearly all of them. structural violence in and around harper seeing the violence. one of the reporters, alex, wrote a new york times piece on this issue saying the ugliness

and inexpolicibility comes to define you and everyone around you. the ground shifts beneath you and you maintain your balance, but it's hard. back at the table to discuss the psychological effects, ira glass, host of "this american life." senior editor at "the atlantic" and the author of "the new york times" peace and part of "this american life", alex, nice to see you. >> thanks for having me. >> alex, let me start with you on this. the devante story and the story of this young man who accidentally shoots his younger brother and is living with the aftermath. what does this tell us about, sort of the psychological impact

and his ability to go on as a student? >> when i was at harper, i planted myself in the social work office a refuge for the kids where they came and felt safe and nurtured as they did in the rest of the school. there's something special about that office back there. devante came in regularly. he had a close relationship with one of the workers, crystal smith. it's clear he was hurting. he felt guilt. he took nyquil to try to get to sleep. before he went to sleep, he looked at photographs of his brother, who he was very close to. at one point toward the end of my stay, i sat down with him. in a very honest way, he talked about how much he didn't like himself. he felt that everybody looked at him differently and you realize this moment came to shape who he

was. i think what crystal was trying to do is let devante know there was somebody else there. it didn't have to shape who he became. as you point out, i mean one example of many, most of those kids in that high school have witnessed an act of violence. it has a profound impact on them. >> ira, i want to ask about the fact he was posted up in the counseling office. the existence of that office and getting to know him long term is because of the resources made available to harper initially. now it may be evaporating. >> exactly. harper was designated a turn around school in chicago. what the people running the schools did was sensible. try to take money off the table and put as much money in as we can to have enough people tending to these kids. that was one of these programs

that lasted. it runs out at the end of this year. $1.6 million out of an $8 million budget. they are going to lose 11 positions including that social work office. it sounds so small when you hear the number. it's 1 1/2 counselors. when you think of the number of counselors who go into a place like sandy hook or columbine to counsel people think seeing the effects of violence. they had this 1 1/2 counselors along with other adults tending to the kids. they are going to lose 11 positions. they will have one 3/4 time counselor. >> this point that ira is making, it's that idea of sandy hook. of the moments we have extraordinary acts of violence and deploy resources into the schools because we recognize, if you were part of that community, you are going to experience

post-traumatic stress. then 1 1/2 counselors for a school that had 29 students shot in a year? >> i study guns and mental health. i thought i knew something about it until i listened to the piece yesterday. it was so profound and disturbing. we are on the wrong track. after things like sandy hook, we talk mental illness and guns as if it's causing the shooting. really, we are looking at the effects of who gets shot in a way. the kids at the school are living with the constant stress of violence. we know from studies of post-traumatic stress disorder, soldiers living under the threat of violence causes stress. these children are living under the threat of violence. if you want to look at the implications of guns, don't look at just who gets shot, look at the impact of living in a violent community like that. it is profound.

>> as i was listening, they are trying to decide whether or not to have the homecoming game and dance because of violence beginning to erupt. within five minutes of making this decision, i'm on edge. my stomach is sick. i'm weeping with the counselor because a child may die. it's so hard for me to listen to my public radio station. these are the realities of these kids in these communities. do we care? nationally, do we fundamentally care? do we get it? >> they are two questions. we care. i don't know how you can listen and not be effected. do we get it is another question. picking up on a point about mental health is a great point. if you grow up in a community like that, god bless you. you may not see anyone get shot. but the very fact of living under threat changes how you think about the world, it changes how you interact with

people. i was listening at the beginning of the show where they lay out rules about where they walk and who they walk with. i'm from west baltimore. i was there 20 to 25 years ago. it's sad that i remember a lot of those rules. every mental illness you spend is taking away from school. it's the point of why you are going there. you are spending, i'm speaking from experience here, one-third to one-half of your brain to secure your safety. >> that's a great point. i want to go to you, alex, on that. the portion of your school day is when you listen to the hours of all the reporting. you get little math class, english class as part of this because they are keeping kids alive. >> there was one point, it's not in the piece but miss sanders talked about missing the days of

being curriculum adviser. now she had to deal with what the kids were bringing into the school building from the neighborhood. another thing that's important is it's not only the kids who are stressed, but the adults. you point to the moment when they are trying to decide to have a homecoming, one of the counselors is asked to come to a homecoming, she says i can't go. she's worried about her own safety. it's going to continue. there's no end in sight. it's an incredible stress on the adults as well. >> alex, thank you so much for joining us from chicago. i want to let everyone know that you can listen to the two episodes of "this american life" for free at thisamericanlife.org or download the podcast through itunes or the public radio iphone app. next, could the solution be as simple as a good meal?

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in this part of the "this american life" of harper high school, a student is standing in the hallway. the student is visibly upset. the student explains the teacher was giving out cookies and he took an extra. >> apparently, the students were given an incentive for being on time. it was food. >> cookies. it was cookies. the student, along with everyone who got to class on time was allowed to go up and take a cookie. this particular student was dealing with a difficult and dangerous situation at his house. he hadn't gone home the night before. because of that, he hadn't

eaten. >> the young man could not eat food because the food was in a home he could not go to. that is called food insecurity. according to a report conducted by, no kid hungry, 3.9 million american families have children without access to nutritious food. joining us, chief officer for no kid hungry. josh, how prevalent is hunger among kids? >> unfortunately, stories like that that ira vividly captured is happening every day around the country at schools as kids struggle with hunger. they speak to teachers. a few months ago, we did a survey of teachers saying almost two out of three teachers in this country currently have kids coming to school hungry because they aren't getting enough to eat. teachers like rose in washington, d.c., blocks from

the national capital say wednesdays and thursdays are the only two effective days to teach because kids on mondays and tuesdays are recovering from the hunger on the weekend and friday, they are filled with aggravation and anticipation of another weekend with not enough food to eat at home. >> we are talking about the sense of insecurity or stress that comes from the violence, but the idea that your monday and tuesday and your friday are impacted by your actual lack and fear and anticipation of lack of food. >> we study this in soldiers. it leads to mental illness and stress. we are recreating these. we can do so much better than this. we talked yesterday with the nra advertisements trying to promote guns in inner cities. i ask well intentioned nra members to listen to this piece and say is that the world that we want to create? >> if we are using part of our

brain power to worry about -- i mean, when i get hungry, i have a hard time concentrating. i'm not going to be hungry for long. i'm going to eat in a couple hours. the idea of asking children, particularly adolescence with the angst they have to manage a day with insufficient food. >> what's interesting here is we are talking about what sounds like all these ancillary issues. again, we are not talking class performance. you can't get to that. you can't get to the point. there was a gentleman talking about how he was doing well in school getting bs and cs. being a parent, i say that's not well in school. if you are talking hunger, being shot at, you know, adding in these extra factors -- >> a b is extraordinary. >> it is. >> they get free breakfasts at

school. there's a program to deal with this problem, every kid that is poor, that is every kid, can get a free breakfast. >> you are right. it's offered. the problem is, so many kids who need it are not getting it. 21 million kids in this country are eligible for a free or reduced price lunch. 11 million only half are getting breakfast. there's a lot of barriers. it's transportation, kids don't get to school early enough. there's stigma associated with it. only the poor kids go to the cafeteria for breakfast while everybody goes for lunch. nobody wants to be that kid. >> if you are serving breakfast in the cafeteria. >> there are ways around the country where schools are working to make that more accessible. they are taking breakfast out of the cafeteria and putting it in the classroom. kids start the day on a level playing field.

principal mack, who we work with sought an instituted breakfast program said i can't think, don't care. he confronted that kid. the kid said to him, he hadn't eaten since lunch the day before. since he's instituted a breakfast program, discipline props are cut in half. throughout the state of maryland, with the maryland meals program, supported by governor o'malley, we have seen suspensions cut in third and tardiness cut in half as well. >> this is a fixable problem. talking violence and talking quality of schools. let's make sure kids aren't hungry. thank you. up next, when good people do racist things. the article heard round the world. announcer ] your smile. like other precious things that start off white, it yellows over time. when it comes to your smile, if you're not whitening, you're yellowing. crest whitestrips whiten as well

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college in ohio canceled classes after a person was spotted wearing a kkk-like robe and hood on campus. the school called for a day of solidarity. more than 1,000 people showed up to make a strong statement about the values their cherished. it's the first race blind admissions policy. they saw eight separate incidences at the college. it's been overt and under investigation by the fbi. the fact that these incidents occurred on one of the most progressive liberal campuses in the country shows racism can and still does happen anywhere, anytime. sometimes, it's more subtle than a kkk robe. as written in a recent new york times piece, the idea that racism lives in the heart of evil individuals as opposed to the heart of a democratic society is reinforcing to anyone who might, from time to time

find their tongue sprinting ahead of their discretion. with me is senior editor of "the atlantic." why this piece and why now? >> i read forest whitaker got frisked, stopped. not just stopped, but somebody put their hands on his body at a deli around the corner from me. a deli i love very much. i have never had problems there. >> forest whitaker. this is about an unknown gentleman. >> yeah. you know, forest whitaker didn't want this out. somebody saw it and it got reported. i have been thinking about that and thinking what happened a few weeks ago. this notion that once we achieve a certain status, which all americans strive for, we don't get the same things. the shadow never goes away.

the ghost of suspicion never goes away. what message that sends, you know, to those of us still striving. >> it feels to me like part of what you are doing is suggesting that we get unfocused when we talk race and racism. we say racism and we say a guy using the "n" word or a guy walking around in a kkk hood. these are the good people. these are the people at the deli that you go to and never had a problem with. next thing you know, they are frisking forest whitaker. >> if you define racist as a good person, it's easy to disqualify yourself. you can see it when people are charged with racism. the first thing they say is my son, father, daughter, good parent, good friend. they take all the things in the community as though you are accusing them of a moral evil. it's been akuwaited wi eed wite

ya. it's a different situation. >> the overland thing, i think hit home for me because of a college campus thing. a girl tweeted. hey, remember the beautiful, inclusive and down right revolutionary place you call home? protect each other. she falls within the category of the thing you have been describing. >> you are putting me in a hard place. i love girls. >> sure, who doesn't. >> here is what i say about that. the fact we live in a world where we live in a world where certain people tell stories is a part of this. it's what i long maintain. we often talk about schools and there's all this talk about the achievement gap. when no one wants to tell these kids, i understand. there's a rewards gap.

if you go to school and do everything right and become the president of the united states, someone may stand-up and ask for your papers. that's still out there. there's no amount of achievement that can make that go away. kids hear that. they receive that. i hate to say this, but my son knows he can't go to that deli. he now knows that. >> we are both parents. obviously, we push, we are achievers and pushing our kids to be achievers. their achievement does not make them safe from the realities of american racism that is deeply inbedded. it doesn't require evil people. >> this is a scary thought. there's a ethos of american individualism. if one person does x, y and z, you can have the world. policy matters. this is a country. it's a democracy. the policies we put in place

matter. there's a reason forest whitaker sticks out in the deli. there's a reason the it didn't happen by magic. it has actual effects. >> these moments, which we think are just about bad actors in the system are actually about the structural segregated world we continue to live. i love 99.9% of what you write. >> i'm going to get that other .1%, man. >> your voice has been so important. >> thank you. >> i appreciate it. >> thank you. >> thank you. in just a few moments, i'm going to say another big thank you. first, one to heaven nicholas. she is in the sixth grade at school 25 in yonkers new york. she chose me as her topic for a black history month project. it tickled me and honored me. i wanted to say thank you. up next, my message to a special 7-year-old and all the other little girls like her.

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this week, i received a letter from dean in california. it read, i volunteer with the second grade class and yesterday, myriam approached me upset that someone made racial remarks to her about being black. such remarks would not be tolerated in her classroom. i know how busy your schedule might be but thought maybe you could give her words of encouragement. it gave me a sick feeling adults have when we experience our children in counter racism for the first time. so many of us have stories ourselves. many black adults who carry the wounds, have gone on to live successful, meaningful, happy lives. we don't spend hours fretting about sixth grade bullies, but the scars remain.

the racial distrust and division of our nation cemented with the scar tissue of these encounters because we suspect a similar day will come for our nieces, sons, sisters and grand kids. but we hope we can delay it. we hope we can make it softer for them. maybe, just maybe this generation will be different, that the doors we opened will stay open long enough for them to pass through unscathed. the slow, halting backtracking difficult work of dismantling racism is not just about law. policy will be part of the effort. it's not just about the health of our national democratic project, although politics will remain sick until we fix it. it's the work of our very souls. one of those souls is myriam. i see you. i see you in a classroom with a teacher who took your feelings

seriously. a dean who wrote to me. it is okay to feel hurt. you don't have to pretend to be strong. it's okay to feel angry because you deserve to be treated with respect. it's okay to ask for help because you deserve to be protected. you are going to survive it and you will thrive. like venus and serena williams and sasha and malia obama, the world is waiting for you. we need the light that you and only you can project. nerdland is here. we are cheering for you, myriam. that is our show for today. thanks for watching. the always wonderful joy reid will sit in with me because i'm running a half marathon with the human rights campaign. join in with joy. coming up, "weekends with alex witt." [ phil ] when you have joint pain and stiffness...

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